Building a telepalliative care strategy in nursing homes: a qualitative study with mobile palliative care teams

BMC Palliative Care - 2021
Clément Cormi1,2, Marie Sophie Petit3, J. Auclair4, Emmanuel Bagaragaza5, Isabelle Colombet6, Stéphane Sanchez1,7
1Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Centre Hospitalier de Troyes, Troyes, France
2LIST3N/Tech-CICO, Troyes University of Technology, Troyes, France
3Unité de soins palliatifs Laroque, CHU Angers, Angers, France
4Service de médecine palliative et d’accompagnement, CHU Bordeaux, Bordeaux, France
5Pôle Recherche et enseignement universitaire (SPES), Maison Médicale Jeanne Garnier, Paris, France
6Université de Paris, APHP Centre, Paris, France
7Fondation Korian pour le Bien Vieillir, Paris, France

Tóm tắt

Abstract Background Despite increasing use of telemedicine in the field of palliative care, studies about the best circumstances and processes where it could replace face-to-face interaction are lacking. This study aimed to: (1) identify situations that are most amenable to the use of telemedicine for the provision of palliative care to patients in nursing homes; and (2) understand how telemedicine could best be integrated into the routine practice of mobile palliative care teams. Methods A qualitative study based on semi-structured focus groups (n = 7) with professionals (n = 33) working in mobile palliative care teams in France. Results Between June and July 2019, 7 mobile palliative care teams participated in one focus group each. Using thematic analysis, we found that telemedicine use in palliative care is about navigating between usual and new practices. Several influencing factors also emerged, which influence the use of telemedicine for palliative care, depending on the situation. Finally, we built a use-case model of palliative care to help mobile palliative care teams identify circumstances where telemedicine could be useful, or not. Conclusions The potential utility of telemedicine for delivering palliative care in nursing homes largely depends on the motive for calling on the mobile palliative care team. Requests regarding symptoms may be particularly amenable to telemedicine, whereas psycho-social distress may not. Further studies are warranted to assess the impact of influencing factors on real-life palliative care practices. Telemedicine could nonetheless be a useful addition to the mobile palliative care teams’ armamentarium.

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